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Primary care spend left to Committee’s final draft

24 May 2017

The Oireachtas Committee on the Future of Healthcare was due to finally agree a percentage of the health budget that should be spent on primary care at a meeting on Tuesday, with the final report due for release next week.

According to earlier leaked drafts of the report, the Committee recommended ring-fencing at least 10 per cent of the health budget for mental health, compared to the 6 per cent currently allocated and the 8.25 per cent recommended in A Vision for Change.

Early drafts also suggested 3 per cent should go to health and wellbeing, but the figure for primary care was left blank.

Speaking to IMT last weekend on the fringes of the NAGP AGM, Dr Michael Harty TD, a member of the Future of Healthcare Committee, acknowledged that this was a figure the Committee had problems identifying.

“From a GP point of view, we are spending less than 3 per cent of our health budget on general practice, and this should be up to something closer to 8-9 per cent,” said the Chair of the Oireachtas Health Committee, in reference to the 9 per cent spent in the UK.

“We have been looking at evidence from other countries, but it has been difficult to disentangle general practice spending from primary care,” said Dr Harty, who stressed that a figure would have to be agreed on by this Tuesday (May 23), when the Committee was due to sign off on the final draft.

The report on a radical transformation and reorientation of the health service, provisionally dubbed ‘Sláinte Care’ by the Independent TD, is aimed at establishing a universal, single-tiered service delivered on medical need and not on ability to pay.

The report is due to be published on either May 30 or 31 — just days before the new leader of Fine Gael is elected.

Speaking at a sometimes heated debate at the NAGP AGM in Maynooth on the imminent release of the report, Dr Harty stressed that whoever was the new Taoiseaach would have to back the proposals to the hilt.

“If we don’t have political buy-in from the highest political authority then I think we are going to be in serious trouble. We really need the highest political support and political drive to bring this plan to fruition,” added the Clare TD.

“This ‘highest level’ is the Taoiseach — it has to go above the Department of Health.”

However, there was concern expressed that this was going to ‘nationalise’ general practice — the one area of the health service that wasn’t broken.

Dr Stephen Murphy, Cabinteely GP and Officer with the NAGP National Council, questioned Deputy Harty on whether GPs would be compensated for the loss of their private practice. “Are the GMS payments suddenly going to double or treble — because that is what they will actually need to do to enable us to provide this aspirational service.”

He added that the system in the UK was “failing miserably”. “We get all excited when we can’t fill 10 training places; they can’t fill 60 per cent… And yet we are proposing to make these changes.”

On the proposed name for the new service, Dr Murphy — in deference to our outgoing Taoiseach — suggested ‘Enda Care’, to some amusement.

NAGP President Dr Emmet Kerin also expressed concern that there could be an “attrition rate” associated with such a paradigm shift. “When you look at Canada back in the 1980s, when they brought in universality, they went through some horrendous years… practices weren’t able for it. My hope is that we will not have to live through a scenario like that.”

Others were more optimistic, however, including Tipperary GP Dr Lucia Gannon (“We need to get behind this”) and Kilkenny GP Dr Ronan Fawsitt, who stressed that the current system needed to change, and there was no plan B.

“We, as a profession, need to get behind this if we can,” he implored his colleagues.

The post Primary care spend left to Committee’s final draft appeared first on Irish Medical Times.

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